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REGIONAL ANESTHESIA

Unintentional Intrapleural Insertion of an Epidural Catheter: Should We Remove It or Leave It In Situ to Provide Perioperative Analgesia?

Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan

Address correspondence and reprint requests to Satoki Inoue, MD, Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. Address e-mail to seninoue{at}naramed-u.ac.jp

We report three patients who had intrapleural insertion of an intended thoracic epidural catheter. These misplaced catheters were used for local anesthetic administration. Bupivacaine injection via these catheters in two cases was effective for reducing postoperative pain. We conclude that if an intended thoracic epidural catheter is found to be in the intrapleural cavity at the time of surgery and if correct replacement of the catheter into the epidural space is not believed to be feasible after surgery, then the administration of local anesthetic through the intrapleural catheter could be considered as a potential alterative analgesic method.

IMPLICATIONS: In cases in which an intended thoracic epidural catheter is found to be in the intrapleural cavity at the time of surgery, the administration of local anesthetic through the intrapleural catheter could be a potential alterative postoperative analgesic method.

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